Living kidney donors are healthy at the time of donation. Consequently, a long observation period is necessary to detect possible detrimental effects of donation. Most studies on mortality after kidney donation have had a short follow-up time of around six years.

In a previous study, we compared long-term mortality in kidney donors against a control group of individuals who would have been eligible for donation. We found increased mortality in previous kidney donors with median follow-up of fifteen years after donation. Since long-term data are scarce in this population, we repeated the main statistical analyses after five more years of follow-up.

Only donors and controls satisfying standard criteria for kidney donation were included. Survival analyses were performed with cox regression. Missing data were handled with multiple imputation. Gender, age, smoking, systolic blood pressure, BMI and year of donation were entered as covariates.

All-cause- and cardiovascular mortality was identified in 1901 individuals with a median follow-up of 20 years (range 0.5-50 years). A control group of 32,621 potentially eligible kidney donors was included, with a median follow-up of 25 years. Hazard ratio for all-cause mortality was increased at 1.43 (95% confidence interval 1.24-1.64, p<0001) for donors compared with controls. There was a corresponding increase in cardiovascular death (HR 1.35 (1.04-1.74, p=0.02)).

In conclusion, kidney donation is associated with increased mortality after a median follow-up time of 20 years. There is need for further studies with long term follow-up in kidney donors. Since donors are healthy, studies with shorter follow-up periods may fail to detect increased mortality.

CITATION INFORMATION: Mjoen G, Hallan S, Holdaas H. Increased Long-Term Mortality 20 years After Living Kidney Donation. Am J Transplant. 2017;17 (suppl 3).

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